溃疡性结肠炎合并中毒性巨结肠六例及文献复习

Toxic megacolon complicated by ulcerative colitis in six patients：a case report and literature review

目的总结溃疡性结肠炎（UC）合并中毒性巨结肠患者的临床特点，为临床早期诊断、及时治疗提供依据。方法总结分析1983--2010年北京协和医院6例UC合并中毒性巨结肠病例的临床特点、治疗及转归，并结合国外相关文献进行分析。结果中毒性巨结肠在北京协和医院UC患者中发病率为0．7％（6／824），低于国外文献报道。其发病存在诱因，虽经内科保守治疗与手术治疗，但预后不佳。国外文献认为应积极评价患者临床情况，在正确的时机及时行手术治疗，有助于改善预后。结论早期识别UC合并中毒性巨结肠患者，并在正确的时机选择急诊手术或择期手术是改善患者预后的关键。

Objective To summarize the clinical features of ulcerative colitis （UC） complicated by toxic megaeolon for early diagnosis and proper treatment. Methods Six cases of toxic megacolon in the patients suffered from UC in Peking Union Medical College Hospital from 1983 to 2010 were analyzed, and relaled literature was searched and reviewed. Results The incidence of the toxic megacolon in the patients with UC in our center was 0. 7% （6/824） , which was lower than those reported in the literature. There were always risk factors triggering the disease. The prognosis of the patients was poor, even after medical care and surgery intervention. Evaluation of the patients and making right timing to perform the surgery would improve the prognosis of the patients in foreign literature. Conclusion It＇s crucial to make early diagnosis of the toxic megacolon in the patients suffered from UC. The right choice and timing to perform urgent surgery or selective surgery may improve their prognosis.